Strategies for improving the quality of life in age-related diseases: precision nutrition approaches

• Autores: Cristina Galarregui Miquelarena
• Directores de la Tesis: Itziar Abete Goñi (dir. tes.)
• Lectura: En la Universidad de Navarra ( España ) en 2021
• Idioma: español
• Tribunal Calificador de la Tesis: Iciar Astiasarán Anchía (presid.), Amelia A. Martí del Moral (secret.), María Adoración Romaguera Bosch (voc.), Helen Hermana Miranda Hermsdorff (voc.), Viviana Loria Kohen (voc.)
• Programa de doctorado: Programa de Doctorado en Alimentación, Fisiología y Salud por la Universidad de Navarra
• Materias:
  • Ciencias médicas
    • Ciencias de la nutrición
      • Necesidades alimentarias
• Enlaces
  • Tesis en acceso abierto en: Dadun
• Resumen

  • A projected doubling in the global human population aged 60 years and over by 2050 has a dramatic impact on overall health and economics. Global nutrition recommendations are not having the expected beneficial effect on reducing the incidence of chronic disease and burdens of unhealthy ageing. Effective nutritional strategies are required in the prevention and management of age-related chronic diseases, focusing on an early diagnosis and prognosis of all these diseases. Nutritional research and guidelines focus on population averages. However, the high inter-person variability in response to foods and diets demands the development of group-based nutrition and precision approaches to optimize the quality of diet and food intake in adults. Thus, the general objective of the current research was to evaluate the plausible role of nutritional factors and dietary patterns in the development and management of age-related chronic diseases including obesity, insulin resistance (IR) and non-alcoholic fatty liver disease (NAFLD), as well as to assess the potential role of blood biomarkers for an early detection of these age-related diseases, to promote an active and healthy ageing. In Chapter 1, the acute effects of different test foods varying in the macronutrient composition on postprandial glycemic response were assessed. Whether these outcomes are influenced by the basal state of the subjects or not were also explored. We found that postprandial glycemic responses were affected not only by the macronutrient composition of foods but also by the glucose metabolism of the subjects in adults, reinforcing the importance of the identification of impaired postprandial glucose metabolism in apparently metabolically healthy adults. In Chapter 2, the potential associations of different dietary indices -total antioxidant capacity (TAC), glycemic index (GI), and glycemic load (GL)- with IR traits in subjects with overweight/obesity and NAFLD were evaluated. Cross-sectional analyses suggested that participants with a higher dietary GI and GL showed increased HOMA-IR values. Moreover, dietary TAC was associated with lower insulin, HOMA-IR, and hepatic fat content. Importantly, the dietary TAC was inversely associated with the GI and GL. Potential associations of specific dietary amino acids -aromatic amino acids (AAA), branched-chain amino acids (BCAA) and sulphur amino acids (SAA)- with hepatic, glucose, and iron metabolism markers were analysed in these participants (Chapter 3). A higher intake of dietary BCAA, SAA and AAA was associated with worse liver health and, to a lesser extent with impaired glucose metabolism. Dietary patterns should consider BCAA, SAA and AAA levels for the management of NAFLD and associated IR. The potential associations of ferritin with hepatic and glucose alterations were explored and the usefulness of different blood biomarkers including ferritin for an early diagnosis of NAFLD in subjects with overweight or obesity was investigated (Chapter 4). Serum ferritin was associated with impaired liver health and glucose metabolism. Moreover, a panel combination consisting of serum ferritin, alanine aminotransferase (ALT) and glucose showed the major predictive ability for liver fat quantification. Finally, the effects of a personalised dietary intervention based on the inclusion of functional foods and digital tools on general health status was assessed within a 3-month follow-up in subjects with overweight/obesity (Chapter 5). Interestingly, the precision nutrition approach enhanced quality of life and emotional well-being, with additional improvements in body composition and metabolic health. Overall, the results of the present investigation have demonstrated that personalised nutrition strategies are effective for a better prevention, management, and diagnosis of age-related diseases including obesity, IR and NAFLD, to enhance the quality of life and reduce the burden from chronic disease.